With help from Matt DoBias, Jennifer Haberkorn, Joanne Kenen and Brett Norman

WATCHING OUT FOR REPEAL FLIPPERS – This week’s House vote on repealing President Barack Obama’s health law could have all the suspense of a summer rerun — unless additional Democrats defect to support repeal. The floor debate starting today is likely to mirror the partisan rancor that has been replayed more than two dozen times over the last 18 months as the House has taken up repeal or defunding of the health law, only to see the measures die in the Senate — just like this one will. Only three Democrats supported full repeal in January 2011: Reps. Dan Boren, Mike McIntyre and Mike Ross. Since then, several other Democrats have supported partial repeal or have made other moves to align themselves with conservatives as they enter difficult reelection battles. So far, only one Democrat, Rep. Larry Kissell of North Carolina, has said he will join pro-repeal ranks when the House votes tomorrow. The POLITICO Pro story: http://politico.pro/RUvsuH

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Happy Tuesday and welcome to PULSE. In preparation for tomorrow’s full repeal vote, we dug up the POLITICO story on the last time the House did this, Jan. 19, 2011: http://politi.co/hCElrI. Doesn’t that seem like ancient history now? Or just like yesterday? We’re not sure either.

--WISCONSIN LEAVES MEDICAID DOOR OPEN – Gov. Scott Walker’s top health official said the state isn’t planning to take up the ACA Medicaid expansion, but that could be a different story come November. http://politico.pro/NkG5lB

HOUSE REPEAL DEBATE SOUNDS A FAMILIAR TONE — Republicans and Democrats telegraphed what the next two days of debate are going to sound like in the run-up to Wednesday’s repeal vote, and it’s not going to be pretty. Familiar? Absolutely. But definitely not pretty. During the House Rules Committee late Monday, Republicans bashed the law for its nearly two dozen new taxes, Medicare cuts, cost overruns and for putting a wedge between the doctors and patients. Democrats countered by saying the law expands coverage to nearly all Americans, creates new jobs and prevents unpopular insurance industry practices.

--WHAT’S NEW, REPUBLICAN EDITION — Now that the Supreme Court has called the individual mandate a tax, Republicans followed suit. Repeatedly. “It’s a tax,” said Rep. Pete Sessions (R-Texas). “What we can’t escape is the cost. I would say to you that means if we do not repeal the bill, then we’ll have to figure out how we double the taxes — how we pay for the bill.”

--WHAT’S NEW, DEMOCRAT EDITION — Democrats took every opportunity to remind Republicans that the focus should be on the economy and job growth, not repealing the health care law. “It just seems like almost every other day we have an effort to repeal this thing,” said Rep. Frank Pallone (D-N.J.). “It’s like Groundhog Day around here. I’m just tired of it.”

WHITE HOUSE THREATENS VETO — Here’s the administration’s veto threat on H.R. 6079: “The administration strongly opposes House passage of H.R. 6079 because it would cost millions of hard-working middle class families the security of affordable health coverage and care they deserve. It would increase the deficit and detract from the work the Congress needs to do to focus on the economy and create jobs.”

ACA HEARINGS ON TAP — Two House Oversight subcommittees are holding ACA hearings today. The first one, at 10 a.m., examines the law’s impact on doctors and patients. The second one, at 1:30 p.m., addresses the law’s impact on job creators and the economy. … At 10:30 a.m., the House Ways and Means Committee holds a hearing on the tax ramifications of the Supreme Court’s health care decision.

--GOP STACKS PANEL AGAINST ACA – It turns out that the House Oversight’s health panel hearing on physician and patients is a little shy on both fronts. The panel includes an orthopedic surgeon (one of the highest-paid health care specialties), a president of a medical device company and a top official from a political group organized in opposition to the law. Missing from the list are representatives from the primary care ranks, as well as those from the major hospital and physician groups. Also, a committee spokesman said the House GOP Doctors Caucus may join in to question the witnesses. The witness list: http://1.usa.gov/LWU6Wk

--WITH THEIR ONE PICK, THE DEMS TAKE POLLACK — Families USA Executive Director Ron Pollack will carry the ball for the administration at the hearing. “I’m going to focus on the absurdity of the House voting for the umpteenth time to repeal the Affordable Care Act,” Pollack said. “And here’s this legislation that has the support of virtually all the key health provider organizations, and so they’ve had to scrounge to find ideologically tainted folks to swim against the tide of strong provider support for the Affordable Care Act.”

OBAMA QUIETLY SIGNED THE FDA BILL – President Barack Obama signed the FDA Safety and Innovation Act yesterday, and for all PULSE knows, he may have just used one pen and the back of an aide. No public photo op for the Republicans and Democrats who worked on the bill for the last 18 months. No formal signing ceremony. Just a simple notice from the White House press secretary that the deed was done. The email hit PULSE’s inbox as FDA Commissioner Margaret Hamburg and other officials were briefing reporters on a conference call about measures the FDA was taking to manage the risk of prescription painkiller abuse. That’s how anticlimactic it was.

--FDA UNVEILS REMS FOR LONG-LASTING PAINKILLERS – Instead of the FDA bill, Hamburg was talking about a new step the administration is taking to curb prescription drug abuse. Yesterday, the agency unveiled its new Risk Evaluation and Management Strategy for long-acting and extended-release opioids, a commonly abused class of drugs meant to manage severe pain when used appropriately. By no later than March of next year, the program will require more than 20 companies making more than 30 products to provide prescribers with continuing education — modeled on an FDA blueprint — about the benefits and risks of the drugs. Participation by providers is voluntary, although Hamburg and Gil Kerlikowske, director of the Office of National Drug Control Policy, made clear that the administration would like to work with Congress to develop some form of mandatory prescriber education. FDA will audit the educational program, which is expected to reach 60 percent of prescribers within three years. The measure also requires the drugmakers to provide a one-page, easy-to-read notice about the drugs to patients at the pharmacy. The REMS plan: http://1.usa.gov/NViwzP

CAN HEALTH CARE MAKE N.Y. SWING? – You don’t normally think of New York as a swing state, but no fewer than eight seats are in play there in November. Health care is already emerging as a major issue, as Democrats target Republicans in traditionally moderate seats. The DCCC launched online ads slamming Reps. Chris Gibson and Nan Hayworth for their health care stances as the House GOP is set to vote again on repeal. On the right, the American Action Network went up with ads that portrayed Reps. Louise Slaughter, Bill Owens and Tim Bishop as “three stooges” who voted for the law. With so many seats in play, both sides are preparing for all-out war. The POLITICO story: http://politi.co/LDcxFR

LONG-TERM CARE GROUP HITS HILL – More than 400 long-term care owners, operators and caregivers, all part of the American Health Care Association, will flood the Hill today to lobby lawmakers on three key issues: Medicare billing auditors, Medicaid provider taxes and changes to Medicare’s observation policies. The association members are slated to meet with Reps. Bill Cassidy (R-La.), Nan Hayworth (R-N.Y.) — both physicians — and Kathy Castor (D-Fla.).

GOING GLOBAL: The big global HIV/AIDS conference, AIDS2012, convenes in Washington later this month under the banner of “Turning the tide together.” This month’s Health Affairs is out with lessons learned from the President's Emergency Plan for AIDS Relief (PEPFAR) — and the promise of achieving “a world free of AIDS.”

--Ambassador Eric Goosby, US Global AIDS Coordinator in the State Department, writes that PEPFAR-supported programs provided antiretroviral treatment for nearly 4 million people in 2011 and prevented 200,000 infants from becoming infected.

--Joe Fu, who works on Global AIDS at State, and colleagues noted that the U.S. once was the model for PEPFAR, but now PEPFAR has “created a knowledge base of how to provide HIV/AIDS prevention, care and treatment services in low-resource settings” that may help the U.S.

--Of course the volume isn’t too rosy. Millions of those infected don’t yet have access to treatment. And untold numbers of preventable infections won’t be prevented. But many of the remaining challenges are about logistics and money, not about knowledge and science. The special Health Affairs volume: http://bit.ly/LZ78a1. Goosby’s article: http://bit.ly/OSEtEr. Fu’s: http://bit.ly/NcqrKE

LePAGE SORRY FOR ‘GESTAPO’ REMARK — Maine Gov. Paul LePage on Monday apologized for saying over the weekend that the ACA turns the IRS into the “new Gestapo.” In a statement, the Republican governor said he didn’t mean to insult anyone, “especially the Jewish Community, or minimize the fact that millions of people were murdered. Clearly, what has happened is that the use of the word Gestapo has clouded my message.” His statement: http://1.usa.gov/NVRcRS

HAPPENING TODAY — The House Judiciary Committee is scheduled at 10 a.m. to mark up H.R. 3803, a bill banning abortion in Washington, D.C., after 20 weeks. … Rep. Tom Price (R-Ga.) and Sen. John Barasso (R-Wyo.) address a Crossroads GPS/American Action Network event, “Obamacare: Then and Now.” … HIV/ADIS policy advocates hold a 10 a.m. briefing at the National Press Club ahead of the XIX International Aids Conference.

TRIVIA TIME – It’s not too late to sign up for the next round of POLITICO Pro trivia. The fun starts tonight at 6 p.m., with POLITICO’s Patrick Gavin and Pro’s Tony Romm hosting the festivities. Pro subscribers can RSVP with their teams of four to awilliams@politico.com.

WHAT WE’RE READING

HHS Secretary Kathleen Sebelius, writing in The Washington Post, tries to debunk what she describes as false claims from ACA opponents. http://wapo.st/NXahmR

The feds have already faced off with the states on two major health care expansions — Medicaid and CHIP — and both times, all the states eventually opted in, The Washington Post writes. http://wapo.st/NWKriK

NYT conservative columnist Ross Douthat writes that it will be a “moral scandal” if the GOP achieves ‘repeal’ but not ‘replace.’ http://nyti.ms/Nl2WAT

WellPoint’s decision to buy Amerigroup underscored insurers’ confidence that the ability for states to opt out of the Medicaid expansion won’t significantly hamper the growth of private Medicaid plans, The Wall Street Journal writes. http://on.wsj.com/LaXHEY

Iowa Gov. Terry Branstad said it would be a “big mistake” for the state to expand Medicaid, The Sioux City Journal reports. http://bit.ly/NElcUB

Seasonal firefighters, many of whom are battling wildfires without health insurance, want the ability to purchase a federal government health plan, The Associated Press reports. http://bit.ly/LKfoYO

** A message from PhRMA: Diabetes is a complex disease affecting more than 30 million Americans – with one-in-ten living in DC, Maryland and Virginia having the disease. Thanks to advances in diabetes care, patients around the country are living longer, healthier lives. Take five-year-old Rhys for example [link to his I’m Not Average profile]. He was diagnosed with type 1 diabetes at 15-months-old, but today, he is a thriving young boy. This is due in large part to new and innovative medicines developed by researchers and scientists at America’s biopharmaceutical companies. Learn more about the medicines in development for diabetes here. **

Authors:

About The Author

Jason Millman is POLITICO Pro’s associate health care editor. He’s on his second tour of duty at POLITICO after a stint at the Washington Post’s Wonkblog and has covered health care since graduating from Boston University with a journalism degree in 2008.